Endoscopic surgical instrument with a handle that can articulate with respect to the shaft

ABSTRACT

A surgical instrument particular suited to endoscopic use is disclosed. Various embodiments include an end effector that is sized to be inserted through a trocar. An elongated shaft assembly is coupled to the end effector and a control handle. The elongated shaft assembly has a distal portion that is adjacent to said the effector for insertion into the trocar. The elongated shaft assembly further has a proximal portion that is remote from the distal portion such that the proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough. The control handle is articulatably coupled to the proximal portion of said elongated shaft assembly to enable the surgeon to move the handle portion to a more ergonomically comfortable position while carrying out the endoscopic procedure. Various articulation joint embodiments and locking arrangements are disclosed.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a divisional application claiming priorityunder 35 U.S.C. §121 to U.S. patent application Ser. No. 11/343,547,entitled “ENDOSCOPIC SURGICAL INSTRUMENT WITH A HANDLE THAT CANARTICULATE WITH RESPECT TO THE SHAFT,” filed Jan. 31, 2006, now U.S.Pat. No. 7,753,904, the entire disclosure of which is incorporated byreference herein.

The present application is related to the following U.S. patentapplications, which are which are incorporated herein by reference intheir entirety:

-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH USER    FEEDBACK SYSTEM-   Inventors: Frederick E. Shelton, IV, John Ouwerkerk and Jerome R.    Morgan, U.S. patent application Ser. No. 11/343,498.-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH LOADING    FORCE FEEDBACK-   Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, Jerome R.    Morgan, and Jeffrey S. Swayze, U.S. patent application Ser. No.    11/343,573.-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE    POSITION FEEDBACK-   Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, Jerome R.    Morgan, and Jeffrey S. Swayze, U.S. patent application Ser. No.    11/344,035.-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH ADAPTIVE    USER FEEDBACK-   Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, and    Jerome R. Morgan, U.S. patent application Ser. No. 11/343,447.-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH    ARTICULATABLE END EFFECTOR-   Inventors: Frederick E. Shelton, IV and Christoph L. Gillum, U.S.    patent application Ser. No. 11/343,562.-   MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH    MECHANICAL CLOSURE SYSTEM-   Inventors: Frederick E. Shelton, IV and Christoph L. Gillum , U.S.    patent application Ser. No. 11/344,024.-   SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER    LOCKING MECHANISM-   Inventors: Frederick E. Shelton, IV and Kevin R. Doll, U.S.    Application Ser. No. 11/343,321.-   GEARING SELECTOR FOR A POWERED SURGICAL CUTTING AND FASTENING    INSTRUMENT-   Inventors: Frederick E. Shelton, IV, Jeffrey S. Swayze, Eugene L.    Timperman, U.S. patent application Ser. No. 11/343,563.-   SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES-   Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, and    Eugene L. Timperman, U.S. patent application Ser. No. 11/343,803.-   SURGICAL INSTRUMENT HAVING A REMOVABLE BATTERY-   Inventors: Frederick E. Shelton, IV, Kevin R. Doll, Jeffrey S.    Swayze and Eugene Timperman, U.S. patent application Ser. No.    11/344,020.-   ELECTRONIC LOCKOUTS AND SURGICAL INSTRUMENT INCLUDING SAME-   Inventors: Jeffrey S. Swayze, Frederick E. Shelton, IV, Kevin R.    Doll, U.S. patent application Ser. No. 11/343,439.-   ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL    ALIGNMENT COMPONENTS-   Inventors: Frederick E. Shelton, IV, Stephen J. Balek and Eugene L.    Timperman, U.S. patent application Ser. No. 11/344,021.-   DISPOSABLE STAPLE CARTRIDGE HAVING AN ANVIL WITH TISSUE LOCATOR FOR    USE WITH A SURGICAL CUTTING AND FASTENING INSTRUMENT AND MODULAR END    EFFECTOR SYSTEM THEREFOR-   Inventors: Frederick E. Shelton, IV, Michael S. Cropper, Joshua M.    Broehl, Ryan S. Crisp, Jamison J. Float, Eugene L. Timperman, U.S.    patent application Ser. No. 11/343,546.-   SURGICAL INSTRUMENT HAVING A FEEDBACK SYSTEM-   Inventors: Frederick E. Shelton, IV, Jerome R. Morgan, Kevin R.    Doll, Jeffrey S. Swayze and Eugene Timperman, U.S. patent    application Ser. No. 11/343,545.

BACKGROUND

The present invention generally concerns endoscopic surgical instrumentsand, more particularly, powered endoscopic surgical instruments.

Endoscopic surgical instruments are often preferred over traditionalopen surgical devices since a smaller incision tends to reduce thepost-operative recovery time and complications. Consequently,significant development has gone into a range of endoscopic surgicalinstruments that are suitable for precise placement of a distal endeffector at a desired surgical site through a cannula of a trocar.

Generally, these endoscopic surgical instruments include an “endeffector”, a handle assembly and an elongated shaft that extends betweenthe end effector and the handle assembly. The end effector is theportion of the instrument configured to engage the tissue in variousways to achieve a desired diagnostic or therapeutic effect (e.g.,endocutter, grasper, cutter, staplers, clip applier, access device,drug/gene therapy delivery device, and energy device using ultrasound,RF, laser, etc.).

The end effector and the shaft portion are sized to be inserted througha trocar placed into the patient. The elongated shaft portion enablesthe end effector to be inserted to a desired depth and also facilitatessome rotation of the end effector to position it within the patient.With judicious placement of the trocar and use of graspers, forinstance, through another trocar, often this amount of positioning issufficient. Surgical stapling and severing instruments, such as thosedescribed in U.S. Pat. No. 5,465,895, are examples of an endoscopicsurgical instrument that successfully positions an end effector byinsertion and rotation.

Depending upon the nature of the operation, it may be desirable tofurther adjust the positioning of the end effector of an endoscopicsurgical instrument. In particular, it is often desirable to orient theend effector at an angle relative to the longitudinal axis of the shaftof the instrument. The transverse or non-axial movement of the endeffector relative to the instrument shaft is often conventionallyreferred to as “articulation”. This articulated positioning permits theclinician to more easily engage tissue in some instances, such as behindan organ. In addition, articulated positioning advantageously allows anendoscope to be positioned behind the end effector without being blockedby the instrument shaft.

Approaches to articulating a surgical stapling and severing instrumenttend to be complicated by integrating control of the articulation alongwith the control of closing the end effector to clamp tissue and firethe end effector (i.e., stapling and severing) within the small diameterconstraints of an endoscopic instrument. Generally, the three controlmotions are all transferred through the shaft as longitudinaltranslations. For instance, U.S. Pat. No. 5,673,840 discloses anaccordion-like articulation mechanism (“flex-neck”) that is articulatedby selectively drawing back one of two connecting rods through theimplement shaft, each rod offset respectively on opposite sides of theshaft centerline. The connecting rods ratchet through a series ofdiscrete positions.

Another example of longitudinal control of an articulation mechanism isU.S. Pat. No. 5,865,361 that includes an articulation link offset from acamming pivot such that pushing or pulling longitudinal translation ofthe articulation link effects articulation to a respective side.Similarly, U.S. Pat. No. 5,797,537 discloses a similar rod passingthrough the shaft to effect articulation. Still other examples ofarticulatable surgical stapling devices are disclosed in U.S. Pat. Nos.6,250,532 and 6,644,532.

Although the above-types of endocutters having articulatable endeffectors provide the surgeon with the ability to accurately move andposition the end effector within the patient, the position of theendocutter handle is dictated by the position of the portion of theshaft that externally protrudes out of the trocar and which is directlyattached to the handle. Thus, the surgeon is unable to move the handleto a more comfortable position. Such arrangements can result in thehandle of the instrument being located in a cumbersome position, makingit difficult for the surgeon to support and operate the device.

Consequently, a significant need exists for an endocutter that has ahandle portion that can be selectively positioned to more ergonomicallyfavorable and comfortable positions relative to the portion of theendocutter that is extending through the trocar into the patient.

SUMMARY

In one general aspect, the present invention is directed to a surgicalinstrument that comprises an end effector sized to be inserted through atrocar. The surgical instrument includes an elongated shaft assemblythat is coupled to the end effector. The elongated shaft assembly has adistal portion that is adjacent to the end effector for insertion intothe trocar with the effector and a proximal portion that is remote fromthe distal portion such that the proximal portion protrudes from thetrocar when the end effector and distal portion are insertedtherethrough. A control handle is articulatably coupled to the proximalportion of the elongated shaft assembly. A locking assembly may beprovided to selectively lock the handle in a desired position relativeto the proximal portion of the shaft assembly.

In another general aspect, the present invention is directed to asurgical instrument that comprises an end effector that is sized to beinserted through a trocar. An elongated shaft assembly is coupled to theend effector and has a distal portion that is adjacent to the endeffector for insertion into the trocar with the end effector and aproximal portion that is remote from the distal portion such that theproximal portion protrudes from the trocar when the end effector anddistal portion are inserted therethrough. The surgical instrumentfurther comprises means for controlling the end effector that isarticulatably coupled to the proximal portion of the elongated shaftassembly.

In another general aspect, the present invention is directed to asurgical instrument that comprises an end effector that is sized to beinserted through a trocar. The surgical instrument further comprises acontrol handle that operably supported at least one drive motor therein.A proximal hollow shaft segment that has a first proximal end isrotatably coupled to the control handle for selective rotation about anelongated shaft axis. The proximal hollow shaft also has a first distalend. The surgical instrument further includes a distal hollow shaftsegment that has a second distal end portion that is operably coupled tothe end effector for selective actuation thereof by axial movement alongthe elongated shaft axis. The distal hollow shaft segment has a secondproximal end portion that is sized to protrude out of the trocar whenthe end effector is inserted through the trocar. A first upper tab and afirst lower tab protrudes from the first distal end of the proximalhollow shaft segment in spaced relation to each other. A second uppertab and a second lower tab protrudes from the second proximal end of thedistal hollow shaft segment in spaced relation to each other. Thesurgical instrument further comprises an upper double pivot link that issized to span between the first and second upper tabs. The upper doublepivot link has a first upper pin pivotally coupled to the first uppertab and a second upper pivot pin is pivotally coupled to the secondupper tab. A lower double pivot link sized to span between the first andsecond lower tabs has a first lower pin that is pivotally coupled to thefirst lower tab and a second lower pin that is pivotally coupled to thesecond lower tab. A proximal spine segment is attached to the controlhandle and extends through the proximal hollow shaft segment such thatit protrudes from the first distal end thereof. A distal spine segmentextends through the distal hollow shaft segment and has a proximal endthat is adjacent a distal end of the proximal spine segment. The distalspine segment has a distal end that is attached to the end effector andis supported within the distal hollow shaft segment such that the distalhollow shaft segment can be selectively axially moved relative to thedistal spine segment. A distal drive shaft portion is operably supportedin the distal spine segment and is coupled to an actuator shaft in theend effector. A proximal drive shaft portion is operably coupled to oneof the drive motors in the control handle and is operably supportedwithin the proximal spine segment. A drive shaft articulation joint iscoupled between the distal drive shaft portion and the proximal driveshaft portion to enable the proximal drive shaft portion to articulaterelative to the distal drive shaft portion when the control handle isarticulated relative to the distal shaft segment.

DRAWINGS

Various embodiments of the present invention are described herein by wayof example in conjunction with the following figures, wherein likenumeral may be used to describe like parts and wherein:

FIG. 1 is a perspective view of a surgical instrument embodiment of thepresent invention;

FIG. 2 is another perspective view of the surgical instrument of FIG. 1with the end effector thereof inserted into a trocar;

FIG. 3 is an exploded assembly view of an end effector embodiment of thepresent invention;

FIG. 4 is another exploded assembly view showing an end effector, driveshaft assembly and elongated shaft assembly of various embodiments ofthe present invention;

FIG. 5A is a cross-sectional view of and end effector and the distalportions of a drive shaft assembly and elongated shaft assembly ofvarious embodiments of the present invention;

FIG. 5B is an enlarged cross-sectional view of the articulation joint ofvarious embodiments of the present invention;

FIG. 6 is an exploded assembly view of an elongated shaft assembly anddrive shaft assembly of various embodiments of the present invention;

FIG. 7 is an exploded assembly view of a control handle of variousembodiments of the present invention;

FIG. 8, is an exploded perspective view of an elongated shaft assemblyand a drive shaft assembly of another embodiment of the presentinvention;

FIG. 9 is an exploded assembly view of the articulation joint of thedrive shaft assembly depicted in FIG. 8;

FIG. 10 is a partial perspective view of the drive shaft articulationjoint and proximal and distal drive shaft portions of variousembodiments of the present invention;

FIGS. 11A-B illustrate a torsion cable that may be employed at thearticulation point between the distal and proximal drive shaft portionsof various embodiments of the present invention;

FIG. 12 is a partial cross-sectional view of a locking assemblyarrangement of various embodiments of the present invention;

FIG. 13 is an end cross-sectional view of the locking assemblyarrangement depicted in FIG. 12;

FIG. 14 is a perspective view of a push button assembly of variousembodiments of the present invention;

FIG. 15 is an exploded assembly view of the pushbutton assembly of FIG.14;

FIG. 16 is a partial plan view of a locking assembly arrangement ofvarious embodiments of the present invention, with some of thecomponents shown in cross-section;

FIG. 17 is a front perspective view of a handle assembly that may beemployed with various embodiments of the present invention with aportion of the housing removed to illustrate the components therein;

FIG. 18 is an exploded assembly view of a gear arrangement that may beemployed in various embodiments of the present invention;

FIG. 19 is a side view of a drive arrangement that may be employed inconnection with various embodiments of the present;

FIG. 20 is another side view of the drive arrangement of FIG. 19;

FIG. 21 is a rear perspective view of the drive arrangement of FIGS. 19and 20; and

FIG. 22 is a front perspective view of the drive arrangement of FIGS.19-21.

DETAILED DESCRIPTION

FIGS. 1 and 2 depict a surgical stapling and severing instrument 10 thatis capable of practicing the unique benefits of the present invention.The surgical stapling and severing instrument 10 comprises a handle 6,an elongated “shaft” or closure tube assembly 1000, and an end effector12 that is operably coupled to the closure tube assembly 1000. In theillustrated embodiment, the end effector 12 is configured to act as anendocutter for clamping, severing and stapling tissue, although, inother embodiments, different types of end effectors may be used, such asend effectors for other types of surgical devices, such as graspers,cutters, staplers, clip appliers, access devices, drug/gene therapydevices, ultrasound, RF or laser devices, etc. While the surgicalstapling and severing instrument 10 is depicted as a motor driven or“powered instrument”, as the present Detailed Description proceeds, theskilled artisan will appreciate that the unique and novel aspects of thepresent invention may also be effectively employed in connection withsurgical stapling and severing instruments and still other endoscopicsurgical instruments that employ mechanical (unpowered) systems foroperating the end effector portion thereof without departing from thespirit and scope of the present invention.

The handle 6 of the instrument 10 may include a closure trigger 18 and afiring trigger 20 for actuating the end effector 12. It will beappreciated that instruments having end effectors directed to differentsurgical tasks may have different numbers or types of triggers or othersuitable controls for operating an end effector. The end effector 12includes in this example, among other things, a staple channel 22 and apivotally translatable anvil 24, which are maintained at a spacing thatassures effective stapling and severing of tissue clamped in the endeffector 12. The handle 6 includes a pistol grip 26 toward which aclosure trigger 18 is pivotally drawn by the clinician to cause clampingor closing of the anvil 24 toward the staple channel 22 of the endeffector 12. The firing trigger 20 is farther outboard of the closuretrigger 18. Once the closure trigger 18 is locked in the closureposition as further described below, the firing trigger 20 may bepivotally drawn by the clinician to cause the stapling and severing ofclamped tissue in the end effector 12.

It will be appreciated that the terms “proximal” and “distal” are usedherein with reference to a clinician gripping the handle 6 of aninstrument 10. Thus, the end effector 12 is distal with respect to themore proximal handle 6. It will be further appreciated that, forconvenience and clarity, spatial terms such as “vertical” and“horizontal” are used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and absolute.

Closure trigger 18 may be actuated first. Once the clinician issatisfied with the positioning of the end effector 12, the clinician maydraw back the closure trigger 18 to its fully closed, locked positionproximate to the pistol grip 26. The firing trigger 20 may then beactuated. The firing trigger 20 returns to the open position (shown inFIGS. 1 and 2) when the clinician removes pressure, as described morefully below. A release button 30 on the handle 6, and in this example,on the pistol grip 26 of the handle, when depressed may release thelocked closure trigger 18.

FIG. 3 is an exploded view of one end effector 12 according to variousembodiments. As shown in the illustrated embodiment, the end effector 12may include, in addition to the previously mentioned channel 22 andanvil 24, a knife and sled driving member 32, a staple cartridge 34, ahelical screw shaft 36 and a bearing 38 that is attached to the channelstructure 22. The anvil 24 may be pivotably connected to the channel 22at a proximate pivot point. In one embodiment, for example, the anvil 24includes laterally projecting pivot pins 25 at its proximal end thatpivotally engage pivot apertures 23 formed near the proximal end of thechannel 22. As will be discussed in further detail below, when theclosure trigger 18 is actuated, that is, drawn in by a user of theinstrument 10, the pivot pins 25 of the anvil 24 may pivot within thepivot apertures 23 in the channel 22 about the pivot point into theclamped or closed position. If clamping of the end effector 12 issatisfactory, the operator may actuate the firing trigger 20, which, asexplained in more detail below, causes the knife/sled driving member 32to travel along the channel 22, thereby cutting tissue clamped withinthe end effector 12.

FIG. 4 is an exploded assembly view of an elongated closure tubeassembly 1000, a drive shaft assembly 1200 and an end effector 12 of oneembodiment of the present invention. FIG. 5 is a cross-sectional view ofa cartridge 34 and distal portions of the elongated shaft assembly andthe drive shaft assembly. FIG. 6 is another exploded assembly view ofthe elongated closure tube assembly 1000 and drive shaft assembly 1200.FIG. 7 illustrates the interface between the elongated closure tubeassembly 1000 and the control handle 6. Turning to FIGS. 4 and 5, it canbe seen that one embodiment of an elongated closure tube assembly 1000includes a distal closure tube segment 1010 that has a “second” distalend 1012 and a “second” proximal end 1014.

In various embodiments, the distal closure tube segment 1010 has aU-shaped window 1016 in its distal end 1012. Such U-shaped window 1016is adapted to engage an upstanding closure tab 27 formed on the anvil24. See FIG. 4. Thus, when the distal closure tube segment 1010 is movedin the distal direction (arrow “A”), it contacts the closure tab 27 andcauses the anvil 24 to pivot to a closed position. When the distalclosure tube segment 1010 is moved in the proximal direction (arrow “B”)it contacts the closure tab 27 and causes the anvil 24 to pivot to anopen position (away from the channel 22).

As can be seen in FIGS. 4 and 6, the elongated closure tube assembly1000 further includes a proximal closure tube segment 1030 that has aproximal end 1032 and a distal end 1034. The proximal end 1032 of theproximal closure tube segment 1030 is articulatably coupled to thedistal end 1014 of the distal closure tube segment 1010 by anarticulation joint generally designated as 1050. More specifically andwith reference to FIGS. 5A, 5B and 6, articulation joint 1050 comprisesin various embodiments a first upper tab 1036 protruding from the distalend 1034 of the proximal closure tube segment 1030 and a first lower tab1038 protruding from the distal end 1034 of the proximal closure tubesegment 1030 in spaced relation to the first upper tab 1036. The firstupper tab 1036 has a first upper pivot hole 1037 therethrough and thefirst lower tab 1038 has a first lower pivot hole 1039 therethrough thatis coaxially aligned with the first upper hole 1037 in variousembodiments. Similarly, the proximal end 1014 of the proximal shaftsegment 1010 has a second upper tab 1020 protruding therefrom and asecond lower tab 1022 protruding therefrom in spaced relation to thesecond upper tab 1020. The second upper tab 1020 has a second upperpivot hole 1021 therethrough and the second lower tab 1022 has a secondlower pivot hole 1023 therethrough that is substantially coaxiallyaligned with the second upper pivot hole 1021. See FIG. 5B.

In various embodiments, the articulation joint 1050 further includes anupper double pivot link 1060 that has a first upper pin 1062 and asecond upper pin 1064 protruding therefrom. The first upper pin 1062 issized to be pivotally received in the first upper pivot hole 1037 andthe second upper pin 1064 is sized to be pivotally received in thesecond upper pivot hole 1021. The upper double pivot link 1060 isretained in position between the proximal end 1014 of the distal closuretube segment 1010 and the distal end 1034 of the proximal closure tubesegment 1030 by the proximal spine tube segment 1100 and the distalspine tube segment 1130. The articulation joint 1050 further includes alower double pivot link 1070 that has a first lower pin 1072 and asecond lower pin 1074 protruding therefrom. The first lower pin 1072 issized to be pivotally received within the first lower pivot hole 1039and the second lower pin 1074 is sized to be pivotally received in thesecond lower pivot hole 1023. See FIG. 5B. The lower double pivot link1070 is retained in position between the proximal end 1014 of the distalclosure tube segment 1010 and the distal end 1034 of the proximalclosure tube segment 1030 by the proximal spine tube segment 1100 andthe distal spine tube segment 1130.

When the upper double pivot link 1060 and the lower double pivot link1070 are attached to the proximal end 1014 of the distal closure tubesegment 1010 and the distal end 1034 of the proximal closure tubesegment 1030, the first upper pin 1062 and the first lower pin 1072 arecoaxially aligned along a first pivot axis D-D that, in variousembodiments, may be substantially transverse to an elongated shaft axisC-C that extends through the elongated closure tube assembly 1000. SeeFIG. 5A. Likewise, the second upper pivot pin 1064 and the second lowerpivot pin 1074 are coaxially aligned along a second pivot axis E-E. Invarious embodiments, the second pivot axis E-E is substantiallytransverse to the elongated shaft axis C-C and substantially parallel tothe first pivot axis D-D. The reader will appreciate that sucharrangement permits the proximal closure tube segment 1030 to pivotrelative to the distal closure tube segment 1010 about pivot axes D-Dand E-E.

As can be seen in FIGS. 6 and 7, the proximal end 1032 of the proximalclosure tube segment 1030 has an attachment groove formed around itscircumference to enable it to be coupled to a carriage assembly 255 thatis supported within the control handle 6 for imparting axial travel ofthe shaft assembly 1000 in the distal and proximal directions A, Brespectively, as will be discussed in further detail below.

Various embodiments of the present invention further include anelongated spine tube assembly, generally designated as 1100 that extendsthrough the elongated closure tube assembly 1000 to support variouscomponents of the drive shaft assembly 1200 therein. In variousembodiments, the elongated spine tube assembly 1100 comprises a proximalspine tube segment 1110 that has a proximal end 1112 and a distal end1114. The proximal end 1112 is adapted to be coupled to an attachmentbar 260 located within the control handle 6 which will be discussed infurther detail below.

As can be seen in FIG. 6, the distal end 1114 of the proximal spine tubesegment 1110 has a lower pivot tab 1120 protruding therefrom, thepurpose of which will be discussed in further detail below. As can alsobe seen in FIG. 6, the proximal spine tube segment 1110 has a firstaxially extending drive shaft hole 1116 extending therethrough forreceiving a portion of the drive shaft assembly 1200 therein as willalso be further discussed below.

The elongated spine assembly 1100 also includes a distal spine tubesegment 1130 that has a proximal end 1132 and a distal end 1134. Thedistal spine tube segment 1130 has an axially extending drive shaft hole1136 therethrough. The distal end 1134 of the distal spine tube segment1130 is also constructed for attachment to the channel 22. In oneembodiment, for example, the distal end 1134 of the distal spine tubesegment 1130 may be formed with a pair of attachment columns 1138 thatare adapted to be retainingly engaged in slots 29 formed in an end ofthe channel 22. See FIG. 3. The attachment columns 1138 may be retainedwithin the slots 29 due to the distal spine segment 1130 being containedwithin the distal closure tube segment 1010 which forces both thechannel 22 and the distal spine segment 1130 to always have the samecenterline and such that the distal end 1134 of the proximal spine tubesegment 1130 is rigidly coupled to the channel 22. The reader willunderstand that the elongated spine tube assembly 1100 is sized relativeto the elongated closure tube assembly 1000 such that the elongatedclosure tube assembly 1000 can freely move axially thereon.

As can be seen in FIGS. 4-6, the drive shaft assembly 1200 is operablysupported within the elongated spine tube assembly 1100 which issupported within the elongated closure tube assembly 1000. In variousembodiments, the drive shaft assembly 1200 comprises proximate driveshaft portion 1202, a drive shaft articulation joint 1220 and a distaldrive shaft portion 1210. The proximal drive shaft portion 1202 is sizedto extend through the elongated drive shaft hole 1116 in the proximalspine tube segment 1110 and may be rotatably supported therein by abearing 1203. The proximal drive shaft portion 1202 has a proximal end1204 and a distal end 1206.

The distal drive shaft portion 1210 is sized to extend through the driveshaft hole 1136 in the distal spine tube segment 1130 and be rotatablysupported therein by a bearing 1207. See FIG. 5B. The distal drive shaft1210 has a proximal end 1212 and a distal end 1214. The distal end 1214has a drive gear 1216 attached thereto that is in meshing engagementwith a gear 56 attached to the helical screw shaft 36. See FIG. 5A.

In one embodiment depicted in FIGS. 4-6, the drive shaft articulationjoint 1220 comprises a first proximal bevel gear 1222 attached to thedistal end 1206 of the proximal drive shaft portion 1202. A clearanceopening 1122 is provided through the first lower pivot tab 1120 toenable the first proximal bevel gear 1222 to rotate relative thereto.This embodiment of the drive shaft articulation joint 1220 furtherincludes a first distal bevel gear 1224 attached to the proximal end1212 of the distal drive shaft portion 1210. An opening 1137 is providedthrough the second lower pivot tab 1135 protruding from the proximal end1132 of the distal spine tube segment 1130 to enable the first distalbevel gear 1224 to freely rotate relative to the second lower pivot tab1135. Also in this embodiment, the drive shaft articulation joint 1220comprises a central bevel gear 1226 that is mounted to a shaft 1228 thatis pivotally mounted in pivot hole 1124 formed in the first lower pivottab 1120 and a pivot hole 1124′ formed in the second lower pivot tab1135. See FIG. 5B. The reader will appreciate that the shaft 1228 servesto pivotally couple the distal end 1114 of the proximal spine tubesegment 1110 to the proximal end 1132 of the distal spine tube segment1130. The central bevel gear 1226 is supported in meshing engagementwith the first distal bevel gear 1224 and the first proximal bevel gear1222 such that rotation of the proximal drive shaft portion 1202 istransmitted to the distal drive shaft portion 1210 through the driveshaft articulation joint 1220 while facilitating articulatable movementof the drive shaft assembly 1200 when the proximal closure tube segment1030 of the elongated closure tube assembly 1000 is articulated relativeto the distal closure tube segment 1010 thereof.

FIGS. 8-10 illustrate an alternative drive shaft articulation joint 1300that may be employed to facilitate substantial universal travel of theproximal drive shaft portion 1202 relative to the distal drive shaftportion 1210. As can be seen in Figure, the elongated closure tubeassembly 1000 and the elongated spine tube assembly 1100 may beconstructed and operate in the manner described above. Turning to FIGS.8 and 10, in this embodiment, the first lower pivot tab 1120 on theproximal spine tube segment 1110 is pivotally coupled to the secondlower pivot tab 1135 on the distal spine tube segment 1130 by a verticalpivot pin 1139. More specifically, the pivot pin 1139 is pivotallyreceived with pivot hole 1124 in the first lower pivot tab 1120 andanother pivot hole (not shown) in the second lower pivot tab 1135 tofacilitate pivotal travel of the proximal spine tube segment 1110relative to the distal spine tube segment 1130 about a pivot axis G-Gwhich is defined by pivot pin 1139.

Also in this embodiment, the drive shaft articulation joint 1300comprises universal joint 1310 that includes a central joint body 1312that is pivotally coupled to a proximal yoke member 1314 and a distalyoke member 1316. As indicated in the above description, the distal end1206 of the proximal drive shaft portion 1202 is rotatably supported inthe proximal spine tube segment 1110 by a bearing 1203. The proximalyoke assembly 1314 is attached to the distal end 1206 of the proximaldrive shaft portion 1202 and is constructed to pivotally receive a pairof proximal pivot pins 1318 that are attached to or otherwise formed inthe central joint body 1312. Such proximal pivot pins 1318 facilitatepivotal travel of the central joint body 1312 relative to the proximaldrive shaft portion 1202 about a proximal pivot axis H-H which may besubstantially transverse to the elongated shaft axis C-C.

Similarly, the distal yoke member 1316 is attached to the proximal end1212 of the distal drive shaft portion 1210. The distal yoke member 1316is adapted to pivotally receive a pair of distal pivot pins 1320attached to or otherwise formed in the central joint body 1312. Suchdistal pivot pins 1320 facilitate pivotal travel about a distal pivotaxis I-I that is substantially transverse to the proximal pivot axis H-Hand the elongated shaft axis C-C.

FIGS. 11A and 11B, illustrate yet another drive shaft articulationarrangement of the present invention that may be employed to facilitatesubstantial universal travel of the proximal drive shaft portion 1202relative to the distal drive shaft portion 1210. In this embodiment, atorsion cable 1390 is attached between the proximal end 1212 of thedistal drive shaft portion 1210 and the distal end 1206 of the proximaldrive shaft portion 1210 to permit the proximal drive shaft portion 1202to articulate relative to the distal drive shaft portion 1210.

Components of an exemplary closure system for closing (or clamping) theanvil 24 of the end effector 12 by retracting the closure trigger 18 arealso shown in FIG. 7. In the illustrated embodiment, the closure systemincludes a yoke 250 connected to the closure trigger 18. A pivot pin 252is inserted through aligned openings in both the closure trigger 18 andthe yoke 250 such that they both rotate about the same point. The distalend of the yoke 250 is connected, via a pin 254, to a first portion 256of the closure bracket 255. The first closure bracket portion 256connects to a second closure bracket portion 258. Collectively, theclosure bracket 255 defines an opening in which the proximal end 1032 ofthe proximal closure tube segment 1030 is seated and held such thatlongitudinal movement of the closure bracket 255 causes longitudinalmotion by the proximal closure tube segment 1030 (and ultimately theelongated closure tube assembly 1000). The instrument 10 also includes aclosure rod 260 disposed inside the proximal closure tube 1030. Theclosure rod 260 may include a window 261 into which a post 263 on one ofthe handle exterior pieces, such as exterior lower side piece 59 in theillustrated embodiment, is disposed to fixedly connect the closure rod260 to the handle 6. In that way, the proximal closure tube segment 1030is capable of moving longitudinally relative to the closure rod 260. Theclosure rod 260 may also include a distal collar 267 that fits into acavity 1111 in the proximal end 1112 of the proximal spine tube segment1110 and is retained therein by a cap 1113 (see FIGS. 6-8 and 12).

In operation, when the yoke 250 rotates due to retraction of the closuretrigger 18, the closure bracket 255 causes the proximal closure tubesegment 1030 to move proximately (i.e., toward the handle end of theinstrument 10), which causes the distal closure tube segment 1010 tomove proximately. Because the tab 27 extends through the window 45 ofthe distal closure tube segment 1010, the tab 27 causes the anvil toopen when the distal closure tube moves proximately. When the closuretrigger 18 is unlocked from the locked position, the proximal closuretube segment 1030 is caused to slide distally, which causes the distalclosure tube segment 1010 to slide distally. The distal closure tubesegment 1010 forces the anvil 24 closed by driving it distally byinteracting with a closure lip 27′ that is distal to tab 27. Furtherclosure is accomplished since the distal movement of the anvil 24 forcesthe anvil pin 25 to move distally up the cam slot 23 in the channel 22,creating compressive loads through this camming action and the hoopconstraint of distal closure tube segment 1010 around the two parts. Inthat way, by retracting and locking the closure trigger 18, an operatormay clamp tissue between the anvil 24 and the cartridge 34 mountedwithin the channel 22, and may unclamp the tissue following thecutting/stapling operation by unlocking the closure trigger 20 from thelocked position.

As shown in FIG. 2, the end effector 12 and the distal end 1012 of thedistal closure tube segment are sized to be inserted through a trocarassembly 900 into the patient. Such trocar assemblies are known in theart and therefore, its construction and operation are not discussed indetail herein. For example, U.S. Pat. No. 6,017,356 to Frederick et al.,entitled METHOD FOR USING A TROCAR FOR PENETRATION AND SKIN INCISION,the disclosure of which is herein incorporated by reference in itsentirety discloses various trocar assemblies. The reader will, ofcourse, appreciate, however, that the various embodiments of the presentinvention may be effectively employed with a variety of differenttrocar, cannula, etc. arrangements without departing from the spirit andscope of the present invention. Therefore, the various embodiments ofthe present invention and their equivalent structures should not in anyway be limited to use with the specific type of trocar described hereinby way of example.

As can be seen in FIG. 2, the trocar assembly 900 includes a cannulaassembly 902 that is attached to a cannula housing 904. The end effector12 and the distal end 1012 of the distal closure tube segment 1010 aresized to be inserted through the cannula housing 904 and cannulaassembly 902 into the patient. Depend upon the procedure to be performedand the location of the organs to be operated on, various lengths of thedistal closure tube segment 1010 may be inserted into the trocar 900.That portion of the closure tube assembly 1000 that is adapted to beinserted into the trocar 900 is referred to herein as the “distalportion” 1002 and could conceivably comprise substantially all of thedistal closure tube segment 1010 up to the proximal end 1014 such thatthe articulation joint 1050 remains external to the trocar 900 and isoperable to permit the surgeon or clinician to articulate the handle 6relative to the distal portion 1002 in the trocar. The reader willfurther appreciate that the distal portion 1002 may comprise somewhatless than the entire length of the distal closure tube segment 1010.Thus, the various embodiments of the present invention enable thesurgeon to articulate the handle 6 of the device 10 to a moreergonomically comfortable position during the operation about the pivotlinks 1060 and 1070.

Various embodiments of the present invention may also be provided with alocking system 1400 that would enable the surgeon to lock the handle ina desired position relative to the portion of the device inserted intothe trocar 900. More specifically and with reference to FIGS. 12-15, onelocking system embodiment may by supported within a rotatable housingassembly 1402 that is attached to the forward portion 7 of the handle 6.In various embodiments, the housing assembly 1402 may comprise a firsthousing segment 1404 and a second housing segment 1406 that areconstructed to fit together to form the housing 1402. The housingsegments 1404, 1406 may be formed from plastic and be constructed to beretained together by snapping arrangements and/or adhesive, screws, etc.As can be seen in FIG. 7, housing segment 1404 has an ring segment 1408formed therein that is adapted to mate with a similar ring segment (notshown) that is formed in the interior of housing segment 1406 to form anannular ring assembly sized to be received in an annular groove 1410formed in the forward portion 1412 of the handle 6. Such arrangementenables the housing assembly 1402 to be coupled to the handle 6 and befreely rotatable relative thereto.

As can be seen in FIGS. 12 and 13, the housing assembly 1402 houses anactuator assembly in the form of a push button assembly 1420. In variousembodiments, the push button assembly 1420 may have a push buttonportion 1422 and a yoke portion 1424 attached thereto. As can be seen inFIG. 13, the push button portion 1422 is adapted to protrude through ahole 1414 formed in the housing 1402 and the yoke portion 1424 isslidably supported within a cavity 1416 formed in the housing 1402. Theyoke portion 1424 has a pair of legs 1426, 1428 that are separated by anend brace 1430. As can also be seen in FIG. 13, the proximal closuretube segment 1030 is received between the legs 1426, 1428 such that theproximal closure tube segment 1030 can move axially therebetween on theproximal spine tube segment 1110. As can be seen in that Figure, theproximal drive shaft portion 1202 is movably supported within theaxially extending hole 1116 in the proximal spin tube segment 1110.

As can be seen in FIGS. 12 and 13, a cable wheel 1440 is rotatablysupported within a wheel cavity 1442 provided in the proximal spine tubesegment 1110 and extends through an opening 1444 in the proximal closuretube segment 1030. Such arrangement permits the cable wheel 1440 tofreely rotate in wheel cavity 1442. Cable wheel 1440 has an uppercable-receiving groove 1446 and a lower cable-receiving groove 1448formed around its perimeter. A right tension cable 1450 is receivedwithin the lower cable-receiving groove and a left tension cable 1460 isreceived within the upper cable-receiving groove. The right tensioncable 1450 is received within a first groove 1115 formed in the outersurface 1113 of the proximal spine tube segment 1110 and the lefttension cable 1460 is received within a second groove 1117 formed in theouter surface 1113 of the proximal spine tube segment 1110. See FIG. 16.The right tension cable 1440 has a distal end 1442 that is attached tothe right side of the proximal end 1132 of the distal spine tube segment1130 and a proximal end that is attached to the cable wheel 1440.Likewise, the left tension cable 1460 has a distal end 1462 that isattached to the left side of the proximal end 1132 of the distal spinetube segment 1130 and a proximal end that is attached to the cable wheel1440. See FIG. 16. Thus, when the proximal closure tube segment 1030 andhandle 6 is articulated relative to the distal closure tube segment1010, the cable wheel 1440 is caused to rotate within the cable wheelcavity 1442 by virtue of tension cables 1450, 1460.

Various embodiments of the locking assembly also include a disengagablegear assembly 1470 for locking the cable wheel 1440 which ultimatelyprevents the proximal closure tube segment 1030 (and handle 6) fromarticulating relative to the distal closure tube segment 1010. Morespecifically and with reference to FIGS. 13-15, the disengagable gearassembly 1470 comprises a first gear 1472 that is attached to the crossbrace 1430 on the push button assembly 1420. A second mating gear 1474is attached to the end of the cable wheel 1440 and is adapted to beselectively meshed with the first fixed gear 1472. The first gear 1472is biased into meshing engagement by a locking spring 1476 that isjournaled on a retainer prong 1478 protruding from the cross brace 1430and received within a spring cavity formed within the housing assembly.Spring 1476 serves to bias the first and second gears 1472, 1474 intomeshing engagement with each other (e.g., in the “K” direction). SeeFigure. When the user pushes the push button 1422 in the “L” direction,the first gear 1472 is moved out of meshing engagement with the secondgear 1474 to thereby permit the second gear 1474 and cable wheel 1440 towhich it is attached rotate.

The locking assembly 1420 may operate in the following manner. When thefirst and second gears 1472, 1474 are in meshing engagement as shown inFIGS. 13 and 14, the cable wheel 1440 cannot rotate and the right cable1450 and left cable 1460 prevent the proximal closure tube 1030 (andhandle) from articulating about the double pivot pins 1060, 1070relative to the distal closure tube assembly 1010. To unlock thearticulation joint 1050, the user pushes the push button 1422 inwardlyto cause the first gear 1472 to disengage the second gear 1474. The usercan then articulate the proximal closure tube segment 1030 (and handle6) relative to the distal closure tube segment 1010. After the surgeonhas articulated the handle 6 to the desired position, the push button1422 is released and the first gear 1472 is biased into meshingengagement with the second gear 1474 to lock the articulation joint 1050in that position. To provide the user with further flexibility, it willbe understood that the housing assembly 1402 and the proximal closuretube segment 1030 and locking assembly 1420 may be rotated relative tothe handle 6 to provide the user with additional flexibility.

FIGS. 17-22 illustrate one aspect of a motorized drive arrangement forpowering the endocutter 10. Various other motorized drive arrangementssuch as those copending U.S. patent applications which have been hereinincorporated by reference above in their entirety could also beeffectively employed in various embodiments. As was also mentionedbefore, however, the unique and novel aspects of the present inventionmay also be practiced in connection with mechanically actuated surgicaldevices, without departing from the spirit and scope of the presentinvention. As can be seen in FIG. 7 and FIGS. 17-22, one exemplaryembodiment includes a gear box assembly 200 including a number of gearsdisposed in a frame 201, wherein the gears are connected between theplanetary gear 72 and the pinion gear 124 at the proximal end 1204 ofthe proximal drive shaft portion 1202. As explained further below, thegear box assembly 200 provides feedback to the user via the firingtrigger 20 regarding the deployment of the end effector 12. Also, theuser may provide power to the system via the gear box assembly 200 toassist the deployment of the end effector 12.

In the illustrated embodiment, the firing trigger 18 includes twopieces: a main body portion 202 and a stiffening portion 204. The mainbody portion 202 may be made of plastic, for example, and the stiffeningportion 204 may be made out of a more rigid material, such as metal. Inthe illustrated embodiment, the stiffening portion 204 is adjacent tothe main body portion 202, but according to other embodiments, thestiffening portion 204 could be disposed inside the main body portion202. A pivot pin 209 may be inserted through openings in the firingtrigger pieces 202, 204 and may be the point about which the firingtrigger 20 rotates. In addition, a spring 222 may bias the firingtrigger 20 to rotate in a CCW direction. The spring 222 may have adistal end connected to a pin 224 that is connected to the pieces 202,204 of the firing trigger 18. The proximate end of the spring 222 may beconnected to one of the handle exterior lower side pieces 59, 60.

In the illustrated embodiment, both the main body portion 202 and thestiffening portion 204 includes gear portions 206, 208 (respectively) attheir upper end portions. The gear portions 206, 208 engage a gear inthe gear box assembly 200, as explained below, to drive the main driveshaft 48 and to provide feedback to the user regarding the deployment ofthe end effector 12.

The gear box assembly 200 may include as shown, in the illustratedembodiment, six (6) gears. A first gear 210 of the gear box assembly 200engages the gear portions 206, 208 of the firing trigger 18. Inaddition, the first gear 210 engages a smaller second gear 212, thesmaller second gear 212 being coaxial with a large third gear 214. Thethird gear 214 engages a smaller fourth gear 216, the smaller fourthgear being coaxial with a fifth gear 218. The fifth gear 218 is a 90°bevel gear that engages a mating 90° bevel gear 220 (best shown in FIG.22) that is connected to the pinion gear 124 that drives the main driveshaft 48.

In operation, when the user retracts the firing trigger 18, a sensor(not shown) is activated, which may provide a signal to the motor 65 torotate at a rate proportional to the extent or force with which theoperator is retracting the firing trigger 18. This causes the motor 65to rotate at a speed proportional to the signal from the sensor. Thesensor could be located in the handle 6 such that it is depressed whenthe firing trigger 18 is retracted. Also, instead of a proportional-typesensor, an on/off type sensor may be used.

Rotation of the motor 65 causes the bevel gears 66, 70 to rotate, whichcauses the planetary gear 72 to rotate, which causes, via the driveshaft 76, the ring gear 122 to rotate. The ring gear 122 meshes with thepinion gear 124, which is connected to the proximal drive shaft portion1202. Thus, rotation of the pinion gear 124 drives the drive, shaftportion 1202, which transmits through the drive shaft articulation joint1220 to the distal drive shaft portion 1210 which transmits to the shaft36 through gears 1216 and 56 to thereby cause actuation of thecutting/stapling operation of the end effector 12.

Forward rotation of the pinion gear 124 in turn causes the bevel gear220 to rotate, which causes, by way of the rest of the gears of the gearbox assembly 200, the first gear 210 to rotate. The first gear 210engages the gear portions 206, 208 of the firing trigger 20, therebycausing the firing trigger 20 to rotate CCW when the motor 65 providesforward drive for the end effector 12 (and to rotate CCW when the motor65 rotates in reverse to retract the end effector 12). In that way, theuser experiences feedback regarding deployment of the end effector 12 byway of the user's grip on the firing trigger 20. Thus, when the userretracts the firing trigger 20, the operator will experience aresistance related to the deployment of the end effector 12 and, inparticularly, to the forward speed of the motor 65. Similarly, when theoperator releases the firing trigger 20 after the cutting/staplingoperation so that it can return to its original position, the user willexperience a CW rotation force from the firing trigger 18 that isgenerally proportional to the reverse speed of the motor 65. The readerwill appreciate however, that the unique and novel articulating handlearrangement of the present invention may be effectively employed inconnection with a myriad of other powered endoscopic instruments,regardless of the particular handle configuration and/or method oftransmitting power to the drive shaft assembly. Accordingly, theprotections afforded to the various embodiments of the present inventionshould not be limited to the particular, motor/handle arrangementdisclosed herein.

It will be appreciated from the foregoing discussion, that variousembodiments of the present invention represent vast improvements overprior endoscopic instruments. In particular, various embodiments of thepresent invention permit the surgeon or clinician to effectivelyposition the handle portion of the instrument relative to the otherportion of the instrument that is inserted into the patient such thatthe handle is in a more ergonomically comfortable position and theposition of the handle is not dictated by the position of the endeffector.

Any patent, publication, or information, in whole or in part, that issaid to be incorporated by reference herein is incorporated herein onlyto the extent that the incorporated material does not conflict withexisting definitions, statements, or other disclosure material set forthin this document. As such the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.

The invention which is intended to be protected is not to be construedas limited to the particular embodiments disclosed. The embodiments aretherefore to be regarded as illustrative rather than restrictive.Variations and changes may be made by others without departing from thespirit of the present invention. Accordingly, it is expressly intendedthat all such equivalents, variations and changes which fall within thespirit and scope of the present invention as defined in the claims beembraced thereby.

What is claimed is:
 1. A surgical instrument, comprising: an end effector sized to be inserted through a trocar, the trocar having an insertion end portion and a proximal end portion; an elongated shaft assembly coupled to said end effector, said elongated shaft assembly defining a longitudinal axis, said elongated shaft assembly having a distal portion adjacent to said end effector for insertion into the trocar with said end effector, a proximal portion remote from said distal portion such that said proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough, and a midpoint; a control handle articulatably coupled to said proximal portion of said elongated shaft assembly; a rotary drive shaft assembly configured to actuate said end effector, wherein said rotary drive shaft assembly is rotatable along said longitudinal axis with respect to said control handle and said end effector, said drive shaft assembly comprising: a non-contourable distal drive shaft portion operably coupled to an actuator shaft in said end effector; a non-contourable proximal drive shaft portion operably coupled to a motor supported in said control handle; and a non-translatable articulation joint comprising a torsion cable coupled between said non-contourable distal drive shaft portion and said non-contourable proximal drive shaft portion to enable said non-contourable proximal drive shaft portion to articulate relative to said non-contourable distal drive shaft portion when said handle is articulated relative to said elongated shaft assembly, wherein said non-translatable articulation joint is positioned proximally with respect to said midpoint of said elongated shaft assembly and proximally with respect to the proximal end of the trocar, and wherein said non-translatable articulation joint is configured to permit said control handle to pivot with respect to said non-contourable distal drive shaft portion.
 2. The surgical instrument of claim 1 wherein said proximal portion of said elongated shaft assembly comprises: a proximal shaft segment having a first distal end and a first proximal end, said first proximal end coupled to said control handle; and a distal shaft segment having a second distal end portion coupled to said end effector and a second proximal end portion sized to protrude out of the trocar when said end effector is inserted through the trocar, wherein said non-translatable articulation joint is attached to said first distal end of said proximal shaft segment and said second proximal end portion of said distal shaft segment.
 3. The surgical instrument of claim 2 wherein said proximal shaft segment is rotatably coupled to said control handle for selective rotation relative to said control handle.
 4. The surgical instrument of claim 2 wherein said non-translatable articulation joint comprises: a first upper tab protruding from said first distal end of said proximal shaft segment; a first lower tab protruding from said first distal end of said proximal shaft segment and in spaced relation to said first lower tab; a second upper tab protruding from said second proximal end portion of said distal shaft segment; a second lower tab protruding from said second proximal end portion of said distal shaft segment in spaced relation to said second upper tab; an upper double pivot link sized to span between said first and second upper tabs, said upper double pivot link having a first upper pin pivotally coupled to said first upper tab and a second upper pivot pin pivotally coupled to said second upper tab; and a lower double pivot link sized to span between said first and second lower tabs, said lower double pivot link having a first lower pin pivotally coupled to said first lower tab and a second lower pin pivotally coupled to said second lower tab.
 5. The surgical instrument of claim 4 wherein said elongated shaft assembly has an elongated shaft axis and wherein said non-translatable articulation joint is constructed to permit said distal shaft segment to pivot about at least one pivot axis relative to said proximal shaft segment.
 6. The surgical instrument of claim 5 wherein said first upper pin and said first lower pin are aligned to define a first pivot axis transverse to said elongated shaft axis and wherein said second upper pin and said second lower pin are aligned to define a second pivot axis transverse to said elongated shaft axis.
 7. The surgical instrument of claim 2 wherein said torsion cable is located within said non-translatable articulation joint coupling said proximal shaft segment to said distal shaft segment.
 8. The surgical instrument of claim 7 further comprising: a proximal spine tube segment attached to said control handle and received in said proximal shaft segment, said proximal spine tube segment operably supporting a portion of said non-contourable proximal drive shaft portion therein; and a distal spine tube segment pivotally coupled to said proximal spine tube segment and supported in said distal shaft segment and attached to said end effector, said distal spine tube segment operably supporting said non-contourable distal drive shaft portion therein.
 9. The surgical instrument of claim 8 wherein said non-translatable articulation joint comprises: a central bevel gear rotatably affixed to a distal end of said proximal spine tube segment and supported between a proximal end of said non-contourable distal drive shaft portion and a distal end of said non-contourable proximal drive shaft portion; a first distal bevel gear coupled to said proximal end of said non-contourable distal drive shaft portion and in meshing engagement with said central bevel gear; and a first proximal bevel gear coupled to said distal end of said non-contourable proximal drive shaft portion and in meshing engagement with said central bevel gear.
 10. The surgical instrument of claim 8 further comprising a locking system cooperating with said elongated shaft assembly and control handle to selectively lock said control handle in desired positions relative to said elongated shaft assembly.
 11. The surgical instrument of claim 10 wherein said locking system comprises an actuator assembly operably supported on said instrument and movable between a locked position and an unlocked position, said actuator assembly communicating with said distal spine segment such that when said actuator assembly is in said locked position, said proximal spine tube assembly is prevented from articulating relative to said distal spine tube assembly and when said actuator assembly is in said unlocked position, said proximal spine tube segment can articulate with respect to said distal spine tube segment.
 12. The surgical instrument of claim 11 wherein said actuator assembly comprises: a push button assembly movably supported within a housing supported on the control handle, said push button assembly comprising: a push button portion; a yoke portion attached to said push button portion, said yoke portion supporting said proximal end of said proximal shaft segment therein, said proximal end of said proximal shaft segment supporting said proximal spine tube segment therein, said yoke portion having a first gear attached thereto; a cable wheel rotatably supported in said proximal spine tube segment that is supported within said proximal end of said proximal shaft segment supported within said yoke portion, said cable wheel having a second gear attached thereto for selective meshing engagement with said first gear; a right tension cable attached to said cable wheel and a right side of a proximal end of said distal spine segment; a left tension cable attached to said cable wheel and a left side of said proximal end of said distal spine segment; and a biaser between said housing and said push button assembly to bias said first gear into meshing engagement with said second gear, when said push button is not activated and to permit said second gear to unmesh with said first gear upon application of an activation force to said push button portion.
 13. The surgical instrument of claim 1 wherein said non-translatable articulation joint comprises a universal joint.
 14. The surgical instrument of claim 1 wherein said non-translatable articulation joint comprises: a central bevel gear rotatably supported between a proximal end of said non-contourable distal drive shaft portion and a distal end of said non-contourable proximal drive shaft portion; a first distal bevel gear coupled to said proximal end of said non-contourable distal drive shaft portion and in meshing engagement with said central bevel gear; and a first proximal bevel gear coupled to said distal end of said non-contourable proximal drive shaft portion and in meshing engagement with said central bevel gear.
 15. The surgical instrument of claim 1 further comprising a locking system cooperating with said elongated shaft assembly and control handle to selectively lock said control handle in desired positions relative to said elongated shaft assembly.
 16. The surgical instrument of claim 15 wherein said non-translatable articulation joint comprises: a proximal yoke member attached to a distal end of said non-contourable proximal drive shaft portion; a distal yoke member attached to a proximal end of said non-contourable distal drive shaft portion; and a central joint body pivotally coupled to said proximal and distal yoke members.
 17. The surgical instrument of claim 16 wherein said central body member is pivotally pinned to said proximal yoke member for pivotal travel about a proximal pivot axis transverse to an elongated shaft axis and wherein said central body is pivotally pinned to the distal yoke member for pivotal travel about a distal axis transverse to said elongated shaft axis.
 18. The surgical instrument of claim 17 wherein said proximal pivot axis is transverse to said distal pivot axis.
 19. A surgical instrument, comprising: an end effector sized to be inserted through a trocar, the trocar having an insertion end portion and a proximal end portion; a elongated shaft assembly coupled to said end effector, said elongated shaft assembly having a distal portion adjacent to said end effector for insertion into the trocar with said end effector, a proximal portion remote from said distal portion such that said proximal portion protrudes from the trocar when the end effector and distal portion are inserted therethrough, and a midpoint; and means for controlling said end effector articulatably coupled to said proximal portion of said elongated shaft assembly, said means for controlling comprising a non-contourable distal drive shaft configured to apply at least one rotary control motion to the end effector, said non-contourable distal drive shaft operably coupled to a non-contourable proximal drive shaft by a torsion cable configured to transmit rotary control motions from the non-contourable proximal drive shaft to the non-contourable distal drive shaft while facilitating selective articulation of the non-contourable distal drive shaft relative to the non-contourable proximal drive shaft, wherein said means for controlling said end effector is positioned proximally with respect to said midpoint of said elongated shaft assembly and proximally with respect to the proximal end of the trocar, and wherein said means for controlling said end effector comprise a non-translatable pivot axis.
 20. A surgical instrument, comprising: an end effector sized to be inserted through a trocar; a control handle operably supporting at least one drive motor therein; a rigid proximal hollow shaft segment having a first proximal end rotatably coupled to said control handle for selective rotation about an elongated shaft axis and a first distal end; a rigid distal hollow shaft segment having a second distal end portion operably coupled to said end effector for selective actuation thereof by axial movement along said elongated shaft axis, said rigid distal hollow shaft segment having a second proximal end portion sized to protrude out of the trocar when said end effector is inserted through the trocar; a first upper tab protruding from said first distal end of said rigid proximal hollow shaft segment; a first lower tab protruding from said first distal end of said rigid proximal hollow shaft segment and in spaced relation to said first lower tab; a second upper tab protruding from said second proximal end of said rigid distal hollow shaft segment; a second lower tab protruding from said second proximal end of said rigid distal hollow shaft segment in spaced relation to said second upper tab; an upper double pivot link sized to span between said first and second upper tabs, said upper double pivot link having a first upper pin pivotally coupled to said first upper tab and a second upper pivot pin pivotally coupled to said second upper tab; a lower double pivot link sized to span between said first and second lower tabs, said lower double pivot link having a first lower pin pivotally coupled to said first lower tab and a second lower pin pivotally coupled to said second lower tab; a proximal spine segment attached to said control handle and extending through said rigid proximal hollow shaft segment and protruding from said first distal end thereof; a distal spine segment extending through said rigid distal hollow shaft segment and having a proximal end adjacent a distal end of said proximal spine segment, said distal spine segment having a distal end attached to said end effector and being supported within said rigid distal hollow shaft segment such that said rigid distal hollow shaft segment can be selectively axially moved relative to said distal spine segment; a non-contourable distal drive shaft portion operably supported in said distal spine segment and being coupled to an actuator shaft in said end effector; a non-contourable proximal drive shaft portion operably coupled to one of said at least one drive motors in said control handle and operably supported within said proximal spine segment; and a torsion cable coupled between said non-contourable distal drive shaft portion and said non-contourable proximal drive shaft portion to enable said non-contourable proximal drive shaft portion to articulate relative to said non-contourable distal drive shaft portion about a non-translatable pivot axis when said control handle is articulated relative to said distal shaft segment.
 21. The surgical instrument of claim 20 further comprising a drive shaft articulation joint, wherein said drive shaft articulation joint comprises: a central bevel gear rotatably affixed to a distal end of said proximal spine segment and supported between a proximal end of said non-contourable distal drive shaft portion and a distal end of said non-contourable proximal drive shaft portion; a first distal bevel gear coupled to said proximal end of said non-contourable distal drive shaft portion and in meshing engagement with said central bevel gear; and a first proximal bevel gear coupled to said distal end of said non-contourable proximal drive shaft portion and in meshing engagement with said central bevel gear.
 22. The surgical instrument of claim 20 further comprising a non-translatable drive shaft articulation joint, wherein said non-translatable drive shaft articulation joint comprises a universal joint.
 23. The surgical instrument of claim 20 further comprising means supported on said instrument for selectively locking said rigid proximal hollow shaft segment in a desired position relative to said rigid distal hollow shaft segment.
 24. A surgical instrument, comprising: an end effector sized and configured to be inserted through a trocar, the trocar comprising an insertion end, a proximal end, and a trocar length extending between the insertion end and the proximal end; a rotatable drive shaft configured to actuate said end effector, said rotatable drive shaft defining a longitudinal axis, wherein said rotatable drive shaft is rotatable along said longitudinal axis with respect to said end effector, said rotatable drive shaft comprising: a non-contourable distal end, wherein said end effector extends from said non-contourable distal end; and a non-articulating portion comprising a non-articulating shaft length which is at least as long as the trocar length; a handle configured to operate said end effector; and a non-translatable articulation joint, wherein said handle is rotatably connected to said shaft about said articulation joint. 